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Differentiating Transient Ischemic Attacks from Stroke Mimics with Radio-Imaging and Angiography

Affiliations

  • Dept. of Neurosurgery, B.J. Govt. Medical College & Sassoon General Hospitals, Pune 411 001, Maharashtra, India
  • DNB Medicine, DNB Cardiology Fellow, India

Abstract


Background: Physicians resistance for radio imaging pose problems differentiating transient ischemic strokes (TIA) from Stroke Mimics (SM). Secondly in hypertensive patients, its progressive- type and severity are ignored.

Objective: 1) Differentiating TIAs from SM with neuro radio imaging and understanding hypertensive behavior.

Materials and Methods: Forty five hypertensive patients with an 'initial-diagnosis' of TIAs were studied retrospectively between year 2008 and 2012. DW- MR radio-imaging and carotid-Digital Subtraction Angiography (DSA) differentiated SM from TIAs for the final diagnosis.

Results: Eight patients of TIAs and one with amaurosis-fugax (AF) included in group 1 category. Radio-imaging showed focal-parenchymal and paraventricular edema in TIAs. AF was due to transient retinal ischemia. The remaining 80% diagnosed as stroke- mimics. These are divided in Group 2-Thirty patients, 66.66% with varied oetiology and Group 3 -Six patients (13.33%) had a final diagnosis of psychosomatic- transient loss of consciousness (P-TLC).

Conclusion: Hypertension history over past eighteen months showed Increasingly-Changing Hypertension (ICh-P) in all stenotic -TIAs cases. Average age for TIAs' in hypertensive males found was 59 years and in hypertensive females 67 years. CAS and hypertension collectively showed long history with 20% incidence of stenotic -TIAs. Incidence of stroke mimics was 80% with mild hypertension.


Keywords

Transient Ischemic Attacks, Stroke-Mimics, Triggers, DW-MRI, Digital Subtraction Angiography.

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References


  • Zhang WW1, Cadilhac DA, Donnan GA, O’Callaghan C, Dewey HM; Hypertension and TIA. Int J Stroke. 2009 Jun; 4(3):206-14.
  • Sutera, S. P ; Skalak, R. (1993) “The history of Poiseuille’s law”. Annual Review of Fluid-Mechanics 25: 1–19. Bibcode: 1993AnRFM.25.1S.doi:10.1146/annurev.fl.25.010193.000245
  • Saver JL, Kidwell C. Neuro-imaging in TIAs. Neurology 2004; 62:S22–25
  • Hughes AD1, Sinclair AM, Geroulakos G, Mayet J, Mackay J, Shahi M, Thom S, Nicolaides A, Sever PS. J Hum Hypertens. 1993 Aug; 7(4):395-7
  • Kannel WB, Dawber TR, Sorlie P, and Wolf PA: Components of blood pressure and risk of atherothrombotic brain infarction: The Framingham Study. Stroke 1976; 7:327-331.
  • R Collins, MBa, R Peto, FRSa, S MacMahon, PhDa, J Godwin, et all ; epidemiology –blood pressure ,stroke and coronory heart disease. The Lancet; Volume 335, Issue 8693, 7 April 1990, Pages 827–838
  • Albers GW, Caplan LR, Easton JD, et al. Transient ischemic attack-proposal for a new definition. N Engl J Med 2002; 347:1713–16.
  • Kannel WB, Dawber TR, Sorlie P, and Wolf PA: Components of blood pressure and risk of atherothrombotic brain infarction: The Framingham Study. Stroke 1976; 7:327-331
  • R Collins, MBa, R Peto, FRSa, S MacMahon, PhDa, J Godwin, et all ; epidemiology –blood pressure ,stroke and coronory heart disease. The Lancet; Volume 335, Issue 8693, 7 April 1990, Pages 827–838
  • Pan Y, Zhao X, Jiang Y, Li H, Wang L, Liu L, Wang C, Jing J, Xu J, Meng X, Zhang M, Li Y, Zhou Y, Zhao W, Wang Y, Wang Y ; Prevalence, Awareness and Control of Hypertension in Patients with Transient Ischemic Attacks in China. Neuroepidemiology. 2016; 46(2):84-7.
  • The World Health Report 2002-Reducing Risks, Promoting Healthy Life. Geneva, Switzerland: World Health Organization; 2002. (http:// www.who.int/whr/2002/en/ n _blank.)
  • Masatoshi Fujishima, M.D., Takao Ishitsuka, M.D. Yasuo Nakatomi, M.D., et al; Kinya Tamaki, M.D., and Teruo Omae, M.D. Changes in Local Cerebral Blood Flow Following Bilateral Carotid Occlusion in Spontaneously Hypertensive and Normotensive Rats. Stroke, Vol 12, No 6, 1981)
  • H. Ay, MD, F.S. Buonanno, MD, G. Rordorf, MD, P.W. Schaefer, MD, et al: Normal diffusion-weighted MRI during stroke-like deficits; Neurology June 1, 1999 vol. 52 no. 9 1784.

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